FCC test EXAM NEW VERSION LATEST UPDATE 2024-2025 WITH ACCURATE ANSWERS GUARANTEED PASS, Exams of Engineering

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FCC test EXAM NEW VERSION LATEST

UPDATE 2024-2025 WITH ACCURATE

ANSWERS GUARANTEED PASS BEST

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QUESTIONS

What is the proper procedure for testing a radiotelephone installation?

• Ans - Transmit the station's call sign, followed by the word "test" on the frequency being used for the test. When testing is conducted on 2182 kHz or Ch-16, testing should not continue for more than ______ in any 5-minute period.
• Ans - 10 seconds. Under GMDSS, a compulsory VHF-DSC radiotelephone installation must be tested at what minimum intervals at sea?
• Ans - Daily. The best way to test the MF-HF NBDP system is?
• Ans - Initiate an ARQ call to a Coast Station and wait for the automatic exchangeof answerbacks. The best way to test the Inmarsat-C terminal is?
• Ans - Compose and send a brief message to your own Inmarsat-C terminal. When may you test a radiotelephone transmitter on the air?
• Ans - At any time (except during silentperiods) as necessary to assure properoperation.

Under normal circumstances, what do you do if the transmitter aboard your ship is operating off-frequency, overmodulating or distorting?

• Ans - Stop transmitting. Which would be an indication of proper operation of a SSB transmitter rated at 60 watt PEP output?
• Ans - In SITOR communications, the power meter can be seen fluctuating regularly from zero to the 60 watt relative output reading. If a ship radio transmitter signal becomes distorted:
  • Ans - Cease operations. What would be an indication of a malfunction on a GMDSS station with a 24 VDC battery system?
• Ans - A constant 30 volt reading on the GMDSS console voltmeter. Your antenna tuner becomes totally inoperative. What would you do to obtain operation on both the 8 MHz and 22 MHz frequency bands?
• Ans - Bypass the antenna tuner. Use a straight whip or wire antenna approximately 30 ft long. Which of the following conditions would be a symptom of malfunction in a 2182 kHz radiotelephone system that must be reported to the Master, then logged appropriately.
• Ans - No indication of power output when speaking into the microphone. What are the antenna requirements of a VHF telephony coast, maritime utility or ship station? - Ans - The shore or on-board antenna must be vertically polarized.

What is the antenna requirement of a radiotelephone installation aboard a passenger vessel? - Ans - The antenna must be verticallypolarized and as non-directional and efficient as is practicable for the transmission and reception of groundwaves over seawater. What is the most common type of antenna for GMDSS VHF?

• Ans - None of the above. What is the purpose of the antenna tuner?
  • Ans - It alters the electrical characteristicsof the antenna to match the frequency in use. What advantage does a vertical whip have over a long wire?
• Ans - It radiates equally well in all directions. A vertical whip antenna has a radiation pattern best described by?
• Ans - A circle. For a small passenger vessel inspection, reserve power batteries must be tested:
  • Ans - At intervals not exceeding 12 months, or during the inspection. What are the characteristics of the Reserve Source of Energy under GMDSS?
  • Ans - Must be independent of the ship's electrical system when the RSE is needed to supply power to the GMDSS equipment. Which of the following terms is defined as a back-up power source that provides power to radio installations for the purpose of conducting Distress and Safety communications when the vessel's main and emergency generators cannot?
• Ans - Reserve Source of Energy.

In the event of failure of the main and emergency sources of electrical power, what is the term for the source required to supply the GMDSS console with power for conducting distress and other radio communications?

• Ans - Reserve source of energy. What is the requirement for emergency and reserve power in GMDSS radio installations?
• Ans - All newly constructed ships under GMDSS must have both emergency and reserve power sources for radio communications. What is the meaning of "Reserve Source of Energy"?
• Ans - The supply of electrical energysufficient to operate the radioinstallations for the purpose of conducting Distress and Safetycommunications in the event of failure of the ship's main and emergency sources of electricalpower. What is an EPIRB?
• Ans - A battery-operated emergency position-indicating radio beacon that floats free of a sinking ship. When are EPIRB batteries changed?
• Ans - After emergency use or within the month and year replacement date printed on the EPIRB. If a ship sinks, what device is designed to float free of the mother ship, is turned on automatically and transmits a distress signal?
• Ans - An emergency position indicatingradio beacon. How do you cancel a false EPIRB distress alert?
• Ans - Notify the Coast Guard or rescue coordination center at once. What is the COSPAS-SARSAT system?

• Ans - An international satellite-based search and rescue system. What is an advantage of a 406 MHz satellite EPIRB?
• Ans - All of the above. In which frequency band does a search and rescue transponder operate?
  • Ans - 9 GHZ How should the signal from a Search And Rescue Radar Transponder appear on a RADAR display?
  • Ans - A series of 12 equally spaced dots. What is the purpose of the SART's audible tone alarm?
• Ans - It informs survivors that assistancemay be nearby. Which statement is true regarding the SART?
• Ans - This is a 9 GHz transponder capable of being received by vessel's X-band navigational RADAR system. At what point does a SART begin transmitting?
  • Ans - If it has been placed in the "on" position, it will respond when it has been interrogated by a 9-GHz RADAR signal. How can a SART's effective range be maximized?
• Ans - The SART should be held as high as possible. Which statement is NOT true regarding the requirements of survival craft portable two-way VHF radiotelephone equipment?

• Ans - Operates simplex on Ch-70 and at least one other channel. Which statement is NOT true regarding the requirements of survival craft portable two-way VHF radiotelephone equipment?
  • Ans - Operation on Ch-13. With what other stations may portable survival craft transceivers communicate?
  • Ans - All of the above. Equipment for radiotelephony use in survival craft stations under GMDSS must have what capability?
  • Ans - Operation on Ch-16. Equipment for radiotelephony use in survival craft stations under GMDSS must have what characteristic(s)?
• Ans - All of these. What is the minimum power of the SCT
  • Ans - One watt. NAVTEX broadcasts are sent:
  • Ans - In categories of messages indicated by a single letter or identifier. MSI can be obtained by one (or more) of the following:
  • Ans - All of the above. Which of the following is the primary frequency that is used exclusively for NAVTEX broadcasts internationally?

• Ans - 518 kHz. What means are used to prevent the reception of unwanted broadcasts by vessels utilizing the NAVTEX system?
• Ans - Programming the receiver to reject unwanted broadcasts. When do NAVTEX broadcasts typically achieve maximum transmitting range?
• Ans - Middle of the night. What is the transmitting range of most NAVTEX stations? - Ans - Typically 200-400 nautical miles (360-720 km). What is a requirement of all marine transmitting apparatus used aboard United States vessels? - Ans - Only equipment that has been certified by the FCC for Part 80 operations is authorized. What transmitting equipment is authorized for use by a station in the maritime services? - Ans - Unless specifically excepted, only transmitters certified by the FederalCommunications Commission for Part80 operations. Small passenger vessels that sail 20 to 150 nautical miles from the nearest land must have what additional equipment? - Ans - MF-HF SSB Transceiver. What equipment is programmed to initiate transmission of distress alerts and calls to individual stations? - Ans - DSC controller. What is the minimum transmitter power level required by the FCC for a medium-frequency transmitter aboard a compulsorily fitted vessel? - Ans - At least 60 watts PEP. Shipboard transmitters using F3E emission (FM voice) may not exceed what carrier power? - Ans
• 25 watts.

Which commercial radio operator license is required to operate a fixed-tuned ship RADAR station with external controls? - Ans - No radio operator authorization is required. When is a Marine Radio Operator Permit or higher license required for aircraft communications? - Ans - When operating on frequencies below 30 MHz not allocated exclusively to aeronautical mobile services. Which of the following persons are ineligible to be issued a commercial radio operator license? - Ans - Individuals who are unable to send and receive correctly by telephone spoken messages in English. What are the radio operator requirements of a passenger ship equipped with a GMDSS installation? - Ans - Two operators on board must hold a GMDSS Radio Operator License or a Restricted GMDSS Radio Operator License, depending on the ship's operating areas. What is the minimum radio operator requirement for ships subject to the Great Lakes Radio Agreement? - Ans - Marine Radio Operator Permit. What is a requirement of every commercial operator on duty and in charge of a transmitting system? - Ans - The original license or a photocopy must be posted or in the operator's personal possession and available for inspection. Radio watches for compulsory radiotelephone stations will include the following: - Ans - VHF channel 16 continuous watch. All compulsory equipped cargo ships (except those operating under GMDSS regulations or in a VTS) while being navigated outside of a harbor or port, shall keep a continuous radiotelephone watch on: - Ans - 2182 kHz and Ch-16. What channel must all compulsory, non-GMDSS vessels monitor at all times in the open sea? - Ans - Channel 16.

When a watch is required on 2182 kHz, at how many minutes past the hour must a 3 minute silent period be observed? - Ans - 00, 30. Which is true concerning a required watch on VHF Ch-16? - Ans - All of the above. What are the mandatory DSC watch keeping bands/channels? - Ans - 8 MHz HF DSC, 1 other HF DSC, 2 MHz MF DSC and VHF Ch-70. Who is required to make entries in a required service or maintenance log? - Ans - The operator responsible for the station operation or maintenance. Who is responsible for the proper maintenance of station logs? - Ans - The station licensee and the radio operator in charge of the station. Where must ship station logs be kept during a voyage? - Ans - At the principal radio telephone operating position. What is the proper procedure for making a correction in the station log? - Ans - The original person making the entry must strike out the error, initial the correction and indicate the date of the correction. How long should station logs be retained when there are entries relating to distress or disaster situations? - Ans - For a period of three years from the last date of entry, unless notified by the FCC. How long should station logs be retained when there are no entries relating to distress or disaster situations? - Ans - For a period of two years from the last date of entry. Radiotelephone stations required to keep logs of their transmissions must include: - Ans - All of these.

Which of the following is true? - Ans - EPIRB tests are normally logged monthly. Where should the GMDSS radio log be kept on board ship? - Ans - At the GMDSS operating position. Which of the following statements is true? - Ans - Key letters or abbreviations may be used in GMDSS Radio Logbooks if their meaning is noted in the log. Which of the following log keeping statements is true? - Ans - Both a) and c) Which of the following statements concerning log entries is false? - Ans - All Safety communications received on VHF must be logged. What regulations govern the use and operation of FCC-licensed ship stations in international waters? - Ans - Part 80 of the FCC Rules plus the international Radio Regulations and agreements to which the UnitedStates is a party. When may the operator of a ship radio station allow an unlicensed person to speak over the transmitter? - Ans - When under the supervision of the licensed operator. Where do you make an application for inspection of a ship GMDSS radio station? - Ans - To the Engineer-in-Charge of the FCCDistrict Office nearest the proposed place of inspection. Who has ultimate control of service at a ship's radio station? - Ans - The master of the ship. Where must the principal radiotelephone operating position be installed in a ship station? - Ans

• In the room or an adjoining room from which the ship is normally steered while at sea.

By international agreement, which ships must carry radio equipment for the safety of life at sea? - Ans - Cargo ships of more than 300 gross tons and vessels carrying more than 12 passengers. What traffic management service is operated by the U.S. Coast Guard in certain designated water areas to prevent ship collisions, groundings and environmental harm? - Ans - Vessel Traffic Service (VTS). What is a bridge-to-bridge station? - Ans - A VHF radio station located on a ship's navigational bridge or main control station that is used only for navigational communications. When may a bridge-to-bridge transmission be more than 1 watt? - Ans - When broadcasting a distress message and rounding a bend in a river or traveling in a blind spot. When is it legal to transmit high power on Channel 13? - Ans - All of these. A ship station using VHF bridge-to-bridge Channel 13: - Ans - May be identified by the name of the ship in lieu of call sign. The primary purpose of bridge-to-bridge communications is: - Ans - Navigational communications. What is the best way for a radio operator to minimize or prevent interference to other stations?

• Ans - Determine that a frequency is not in use by monitoring the frequency before transmitting. Under what circumstances may a coast station using telephony transmit a general call to a group of vessels? - Ans - When announcing or preceding the transmission of Distress, Urgency, Safety or other important messages.

Who determines when a ship station may transmit routine traffic destined for a coast or government station in the maritime mobile service? - Ans - Ship stations must comply with instructions given by the coast or government station What is required of a ship station which has established initial contact with another station on 2182 kHz or Ch-16? - Ans - The stations must change to an authorized working frequency for the transmission of messages. How does a coast station notify a ship that it has a message for the ship? - Ans - The coast station may transmit, at intervals, lists of call signs in alphabetical order for which they have traffic. What is the priority of communications? - Ans - Distress, Urgency and Safety. Under what circumstances may a ship or aircraft station interfere with a public coast station? - Ans - In cases of distress. Ordinarily, how often would a station using a telephony emission identify? - Ans - At the beginning and end of each transmission and at 15-minute intervals. When using a SSB station on 2182 kHz or VHF-FM on channel 16: - Ans - All of these. What should a station operator do before making a transmission? - Ans - Except for the transmission of distress calls, determine that the frequency is not in use by monitoring the frequency before transmitting. On what frequency should a ship station normally call a coast station when using a radiotelephony emission? - Ans - Calls should be initiated on the appropriate ship-to-shore working frequency of the coast station.

In the International Phonetic Alphabet, the letters E, M, and S are represented by the words: - Ans - Echo, Mike, Sierra What information must be included in a Distress message? - Ans - All of the above. What are the highest priority communications from ships at sea? - Ans - Distress calls are highest and then communications preceded by Urgency and then Safety signals. What is a Distress communication? - Ans - An internationally recognized communication indicating that the sender is threatened by grave and imminent danger and requests immediate assistance. What is the order of priority of radiotelephone communications in the maritime services? - Ans

• Distress calls and signals, followed by communications preceded by Urgency and Safety signals and all other communications. The radiotelephone Distress call and message consists of: - Ans - All of the above. What is Distress traffic? - Ans - All messages relative to the immediate assistance required by a ship, aircraft or other vehicle threatened by grave or imminent danger, such as life and safety of persons on board, or man overboard. What is a typical Urgency transmission? - Ans - A request for medical assistance that does not rise to the level of a Distress or a critical weather transmission higher than Safety. What is the internationally recognized Urgency signal? - Ans - The words "PAN PAN" spoken three times before the Urgency call. What is a Safety transmission? - Ans - A communications transmission which indicates that a station is preparing to transmit an important navigation or weather warning.

The Urgency signal concerning the safety of a ship, aircraft or person shall be sent only on the authority of: - Ans - Either Master of ship or person responsible for mobile station. The Urgency signal has lower priority than: - Ans - Distress. What safety signal call word is spoken three times, followed by the station call letters spoken three times, to announce a storm warning, danger to navigation, or special aid to navigation? - Ans - SECURITE. What is the fundamental concept of the GMDSS? - Ans - It is intended to automate and improve emergency communications in the maritime industry. The primary purpose of the GMDSS is to: - Ans - Automate and improve emergency communications for the world's shipping industry. What is the basic concept of GMDSS? - Ans - All of these. GMDSS is primarily a system based on? - Ans - The linking of search and rescue authorities ashore with shipping in the immediate vicinity of a ship in Distress or in need of assistance. What is the responsibility of vessels under GMDSS? - Ans - Every ship is able to perform those communications functions that are essential for the Safety of the ship itself and of other ships. GMDSS is required for which of the following? - Ans - SOLAS Convention ships of 300 gross tonnage or more. What is the purpose of the INT-USA control settings on a VHF? - Ans - To change certain InternationalDuplex channel assignments to simplex in the U.S. for VTS and other purposes.

VHF ship station transmitters must have the capability of reducing carrier power to: - Ans - 1 watt. The Dual Watch (DW) function is used to: - Ans - Listen on any selected channel while periodically monitoring Ch-16. Which of the following statements best describes the correct setting for manual adjustment of the squelch control? - Ans - Adjust squelch control to the minimum level necessary to barely suppress any background noise. The "Scan" function is used to: - Ans - Sequentially scan all or selectedchannels. Why must all VHF Distress, Urgency and Safety communications (as well as VTS traffic calls) be performed in Simplex operating mode? - Ans - To ensure that vessels not directlyparticipating in the communications can hear both sides of the radioexchange. What channel must VHF-FM-equipped vessels monitor at all times when the vessel is at sea? - Ans - Channel 16. What is the aircraft frequency and emission used for distress communications? - Ans - 121. MHz - A3E. Which VHF channel is used only for digital selective calling? - Ans - Channel 70. Which channel is utilized for the required bridge-to-bridge watch? - Ans - VHF-FM on Ch-13 in most areas of the continental United States. Which channel would most likely be used for routine ship-to-ship voice traffic? - Ans - Ch-08. What channel would you use to place a call to a shore telephone? - Ans - Ch-28.

Which modes could be selected to receive vessel traffic lists from high seas shore stations? - Ans

• SSB and FEC. Why must all MF-HF Distress, Urgency and Safety communications take place solely on the 6 assigned frequencies and in the simplex operating mode? - Ans - Answers a) and c) are both correct. To set-up the MF/HF transceiver for a voice call to a coast station, the operator must: - Ans - Select J3E mode for proper voiceoperations. MF/HF transceiver power levels should be set: - Ans - To the lowest level necessary for effective communications. To set-up the MF/HF transceiver for a TELEX call to a coast station, the operator must: - Ans - Select F1B mode or J2B mode, depending on the equipmentmanufacturer. What is the purpose of the Receiver Incremental Tuning (RIT) or "Clarifier" control? - Ans - It acts as a "fine-tune" control on the receive frequency. On what frequency would a vessel normally call another ship station when using a radiotelephony emission? - Ans - On 2182 kHz or Ch-16, unless the station knows that the called vessel maintains a simultaneous watch on another intership working frequency. What is the MF radiotelephony calling and Distress frequency? - Ans - 2182 kHz. For general communications purposes, paired frequencies are: - Ans - Normally used with public coast stations. What emission must be used when operating on the MF distress and calling voice frequency? - Ans - J3E - Single sideband telephony.

Which of the following defines high frequency "ITU Channel 1212"? - Ans - The 12th channel in the 12 MHz band. For general communications purposes, simplex frequencies are: - Ans - Both a) and c) are correct. A 76-year-old woman with a history of congestive heart failure and hypertension is admitted with altered mental status and mild upper respiratory symptoms. According to family, her mental status has been gradually declining over the past 3 days. Because of generalized weakness and upper respiratory symptoms, she has had a limited amount of food and drink for the past 72 hours. Her home medications include metoprolol, lisinopril, and furosemide. Her family states that she has been compliant with these medications. On physical examination, vital signs are: heart rate, 118 beats/min; blood pressure, 96/53 mm Hg; respiratory rate, 14 breaths/min; and oxygen saturation, 98% on room air. Other findings included dry mucous membranes, poor skin turgor, and the absence of jugular venous distention. Pulmonary examination is clear on auscultation. She opens her eyes to voice, but mumbles incomprehensible sounds and has generali - Ans - B. Hypertonic (3%) saline, 100 mL for rapid early correction, with goal serum sodium of 118 mEq/L in 24 hours A 72-year-old woman with a history of hypertension, type 2 diabetes mellitus, and smoking develops sudden-onset severe chest pain associated with difficulty breathing and diaphoresis. Her vital signs on arrival in the emergency department are: blood pressure, 165/92 mm Hg; heart rate, 101 beats/min; respiratory rate, 29 breaths/min; and oxygen saturation as measured by pulse oximetry, 96% on room air. Which of the following ECG findings is the most significant indicator for immediate reperfusion in pt management A. ST segment depression B. ST segment elevation C. T wave inversions D. Peaked T waves - Ans - B. ST segment elevation A 72-year-old man presents to the emergency department with congestive heart failure exacerbation. He is awake and alert but in distress. He is using accessory respiratory muscles and says it is hard to breathe. His vitals signs are: heart rate, 120 beats/min; blood pressure, 120/80 mm Hg; respiratory rate, 34 breaths/min; and oxygen saturation, 90% on 8 L of oxygen

by simple face mask. Physical examination reveals bilateral lower extremity edema and crackles in the posterior lung fields. A chest radiograph demonstrates bilateral fluffy infiltrates consistent with pulmonary edema. Arterial blood gas analysis demonstrates: pH 7.30, PCO2 50 mm Hg, and PO2 64 mm Hg. In addition to diuresis, which of the following is the best next step in this patient's management? A. Intubate and initiate invasive mechanical ventilation B. Initiate noninvasive positive pressure ventilation C. Switch to nonrebreather oxygen mask D. Swi - Ans - B noninvasive positive pressure ventilation A 27-year-old man is admitted to the ICU with a subarachnoid hemorrhage after a motor vehicle crash. On examination, his initial Glasgow Coma Scale score was 8 with labored respirations. He was intubated in the emergency department and placed on a ventilator. Shortly after arrival to the unit, his pulse oximeter (SpO2) reads 57%, with heart rate of 46 beats/min and no pulse. Which of the following is the safest and most immediate method to verify correct endotracheal tube placement? A. Palpation over the epigastrium for abdominal distension B. Manual bag-mask breathing C. Qualitative exhaled carbon dioxide monitor or detector D. Portable chest radiograph - Ans - C exhaled CO2 monitor/detector A 52-year-old man presents after a motor vehicle crash with hypotension and obvious signs of hemorrhagic shock. His focused assessment with sonography in trauma (FAST) examination is positive, and an emergent surgical consultation is obtained for operative intervention. While awaiting the surgeon and transportation to the operating room for definitive hemorrhage control, his blood pressure continues to decline and resuscitation is begun. Which of the following is the best strategy for resuscitation in this setting of massive hemorrhage? A. Infusion of packed red blood cells only until laboratory results are available to assess for the presence of coagulopathy and thrombocytopenia

B. Balanced resuscitation using a combination of packed red blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio C. Limited infusion of IV fluids or blood products until definitive control of hemorrhage is achieved, regardless - Ans - B. RBCS:FFP:Plate 1:1:1 ratio A 75-year-old woman is admitted to the emergency department with altered mental status. A CT scan of her head shows an intracranial hemorrhage. A decision is made to intubate her, but there is concern for increased intracranial pressure. Which of the following pretreatment agents is most appropriate before performing rapid sequence intubation? A. Nimbex B succinylcholine C vecuronium D rocuronium - Ans - B succinylcholine A patient arrives in the emergency department with a respiratory rate of 4 breaths/minute. She is not intubated. Overdose with a centrally acting nervous system depressant is suspected. Which of the following is the most likely finding on the initial blood gas? A. Chronic hypercapnic respiratory failure only B. Acute hypoxemic respiratory failure only C. Mixed hypoxemic and hypercapnic respiratory failure D. Acute hypercapnic respiratory failure only - Ans - D acute hypercapnic resp fail only A 35-year-old man develops acute respiratory distress syndrome from smoke inhalation injury. He is receiving invasive mechanical ventilation in volume assist control mode. His ventilator settings are: tidal volume 350 mL (6 mL/kg ideal body weight), respiratory rate 28 breaths/min, gas flow rate 80 L/min, and positive end-expiratory pressure (PEEP) 10 cm H2O. His plateau pressure on these settings is 26 cm H2O. Arterial blood gas analysis reveals: pH 7.28, PCO2 50 mm Hg, PO2 50 mm Hg, bicarbonate 26 mmol/L, and oxygenation saturation 82%. Which of the following is the most appropriate next step in management? A. Increase PEEP to 14 cm H2O. B. Increase the respiratory rate to 35 breaths/min.

C. Start a bicarbonate infusion. D. Lower the tidal volume to 5 mL/kg ideal body weight. - Ans - A increase PEEP to 14 A 68-year-old man with Crohn disease was admitted with a small bowel fistula. Now on postoperative day 2 after a small bowel resection, he has hematochezia, nausea, vomiting, abdominal pain, and distention. Heart rate is 134 beats/min and blood pressure is 84/52 mm Hg. Hemoglobin is 6.2 g/dL. Pulse oximetry has a poor waveform and readings are poor and inconsistent. Which of the following is the most likely causing the poor pulse oximetry readings A. Drop in hemoglobin B. Excessive nail polish C. Elevated carbon dioxide D. Vasoconstriction - Ans - D vasoconstriction A 46-year-old man with a history of polysubstance abuse, body mass index of 20, and prominent thyroid cartilage is found obtunded. He is intubated and admitted to the ICU. He subsequently regains consciousness, becomes agitated, and violently pulls out his endotracheal tube. He is unable to breathe; attempts to assist him with bag mask ventilation are unsuccessful. Direct laryngoscopy reveals swollen, edematous vocal cords with no glottic opening seen. His oxygen saturation is now 76%. Which of the following methods is most appropriate to re-establish an airway? A. Establish airway patency by using Rapid Sequence Intubation B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for immediate surgical backup C. Placement of a nasopharyngeal airway D. Videolaryngoscopy with size 7.5 endotracheal tube - Ans - B B. Attempt placement of a supraglottic airway (laryngeal mask airway) and call for immediate surgical backup A 53-year-old woman presents to the emergency department with epigastric pain that began acutely. She has tachycardia and hypotension. An upright chest radiograph reveals pneumoperitoneum. Her lactic acid is 4.3 mmol/L. After administering 30 mL/kg normal saline solution, her blood pressure is 78/43 mm Hg and her mean arterial pressure is 55 mm Hg. After the bolus dynamic monitoring demonstrates low pulse pressure variation and an IVC ultrasound

shows little variability with respiration. Which of the following is the most appropriate next intervention to achieve a mean arterial pressure target of 65 mm Hg? A. 1-L bolus of normal saline B norepinephrine C phenylepherine D tx 1 unit whole blood - Ans - B norepinephrine A 51-year-old male, helmeted motorcyclist with a history of hypertension is hit by a car. He is found away from his motorcycle. He is intubated at the scene and transported by helicopter to the nearest trauma center. On arrival, he is unresponsive and on no sedation. Heart rate is around 140 beats/min, blood pressure is 80/40 mm Hg, and he is mechanically ventilated. He has had negligible urine output. He is pale. Massive transfusion protocol is initiated. Which of the following classes of shock is this patient exhibiting? A class I shock B class II shock C class III Shock D class IV shock - Ans - Class IV shock A 55-year-old woman presents to the emergency department with shortness of breath and oxygen saturation 84%. She was discharged from the hospital 2 days ago after a urinary tract infection for which she received IV antibiotics and was sent home on an oral regimen for 5 more days. Blood and sputum cultures are obtained and empiric IV antibiotics are started for presumed nosocomial pneumonia. Which of the following antimicrobial regimens is most appropriate for this patient? A. Cefepime plus levofloxacin plus vancomycin B. Levofloxacin plus tobramycin plus imipenem C. Meropenem plus trimethoprim-sulfamethoxazole plus vancomycin D. Piperacillin/tazobactam plus cefepime plus linezolid - Ans - A. Cefepime plus levofloxacin plus vancomycin

A 55-year-old man with a history of end-stage renal disease on hemodialysis presents to the emergency department with lightheadedness and dizziness. He undergoes dialysis sessions regularly every Monday, Wednesday, and Friday, but he has been told that he has been receiving "lower doses" because his blood pressures have been too low. He is due for dialysis tomorrow. On examination, heart rate is 65 beats/min, blood pressure 87/49 mm Hg, respiratory rate 22 breaths/min, and oxygen saturation 92% while breathing 6-L/min nasal cannula oxygen breaths. His ECG is shown below. While waiting for laboratory results, which of the following is the most appropriate next step in management? A. IV calcium chloride, 10% solution B. Initiation of hemodialysis C. IV sodium bicarbonate, 50 mEq/L D. Oral sodium polystyrene, 25 g - Ans - A. IV calcium chloride, 10% solution Which of the following interventions has shown a reduced risk of infectious complications and mortality in acute pancreatitis? A. Aggressive and early crystalloid resuscitation B early enteral nutrition C. Prophylactic broad-spectrum antibiotics D. Use of pentoxifylline (phosphodiesterase inhibitor) within 24 hours of admission - Ans - B early enteral nutrition Best sedative for intubation r/t hypotension - Ans - Ketamine Thyromental space <2 finger breaths - Ans - Anteriorly displaced larynx = hard intubation Burn formula - Ans - TBSA x (2-4mL/kg) 1st 1/2 in 8hrs 2nd 1/2 in 16hrs

LR fluid of choice Rule of 9's - Ans - Each arm= 9%, Anterior leg=9%, Posterior leg=9% Head=9%, Back=18% Chest=18%, Perineum=1%, palms =1% Most common object to obstruct airway - Ans - Tongue 3 indications for BiPAP - Ans - COPD Short term use (24-48hrs) to tx issue Pulmonary edema evidence of hypoperfusion - Ans - Altered mental status Skin temp decrease, skin changes Decreased urine output Lactic acidosis ^ ALT/AST Always serious illness if - Ans - METABOLIC ACIDOSIS Initial Ventilator Settings - Ans - FiO2 100% Tv (6-8mL/kg ideal body weight) PEEP 5 RR 12- 16 Mode: AC

Plateau pressure - Ans - Pressure to hold air in the lungs < 30mm Hg Tx auto peep - Ans - Decrease Tv & RR